ArizonaBackInstitute

By Randall Pruitt, DC, DACNB, FACFN, DAAPM, MUAC, CES-NASM

In my practice I am often asked my opinion on a number of pain procedures. One that I have been asked about time and again is facet injections. In a recent editorial in the Back Letter the evidence or lack of evidence for facet injections was discussed. Even though the scientific literature has shown that they don’t work there has been a 543% increase in their use over the past several years. What is interesting to me is that many doctors will be quick to bash a treatment like spinal decompression, because they say there is lack of evidence at this point and time. However, when the evidence clearly shows that a procedure like facet injections doesn’t work they discount it and try to somehow justify it’s utilization. It isn’t too hard to see why the Medicare system is failing, for example the cost to Medicare for facet injections was 229 million dollars in 2002 and as recently as 2006 it had gone to 511 million. Can you imagine what it is today? Probably close to a Billion.

This is the type of issue that drives me crazy when it comes to the treatment of back and neck pain. There is so much waste out there and so many procedures that are expensive and unnecessary and most of them don’t offer a long term solution to low back pain or neck pain. A program designed to actually treat the underlying cause and restore function is really what is needed and there are protocols like that, including the program at the Arizona Back Institute.

So if your doctor wants to do facet injections or some other procedure that you’re not sure about, make sure to ask him or her about the evidence, the long term ramifications and the treatment goals before you agree.